Provider Demographics
NPI:1114384112
Name:MARIO J RAMOS, M.D. PA
Entity Type:Organization
Organization Name:MARIO J RAMOS, M.D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-253-6175
Mailing Address - Street 1:2646 W 68TH PL
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5404
Mailing Address - Country:US
Mailing Address - Phone:786-253-6175
Mailing Address - Fax:786-253-6175
Practice Address - Street 1:2646 W 68TH PL
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5404
Practice Address - Country:US
Practice Address - Phone:786-253-6175
Practice Address - Fax:786-253-6175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC12085261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME125217OtherMEDICAL LICENSE